Spontaneous abortion

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Type Presentation Cervix US What to do?
1. TVUS for Dx
2. qB-hCG
Missed No s/s
Vaginal bleeding
Closed Non-viable fetus If unstable: D&C
If stable: Wait, PGs or D&C
Inevitable Vaginal bleeding
Uterine cramps
Open Possible
heartbeat
If unstable: D&C
If stable: wait, PGs or D&C
Incomplete Vaginal bleeding
Passage of clots/tissue
Uterine cramps
Open Products in cervix If unstable: D&C
If stable: wait, PGs or D&C
Threatened Vaginal bleeding Closed Viable pregnancy Rest, wait until resolution or progression
Septic S/S of sepsis
Foul vaginal discharge
Usually due to induced
Open Retained products Blood,
endometrial cultures
Antibiotics
D&C
Complete Vaginal bleeding Closed Stripe F/U